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Related to Cubicin: Tygacil, Targocid


(dap-to-mye-sin) ,


(trade name)


Therapeutic: anti infectives
Pharmacologic: cyclic lipopeptide antibacterial agents
Pregnancy Category: B


Complicated skin and skin structure infections caused by aerobic Gram-positive bacteria.


Causes rapid depolarization of membrane potential following binding to bacterial membrane; this results in inhibition of protein, DNA, and RNA synthesis.

Therapeutic effects

Death of bacteria with resolution of infection.
Active against Staphylococcus aureus (including methicillin-resistant strains), Streptococcus pyogenes, S. pyogenes agalactiae, some S. dysgalactiae, and Enterococcus faecalis (vancomycin-susceptible strains).


Absorption: IV administration results in complete bioavailability.
Distribution: Unknown.
Protein Binding: 92%.
Metabolism and Excretion: Metabolism not known; mostly excreted by kidneys.
Half-life: 8.1 hr.

Time/action profile

IVrapidend of infusion24 hr


Contraindicated in: Hypersensitivity.
Use Cautiously in: CCr <30 mL/min (dose ↓ required);Moderate-to-severe renal impairment (may have ↓ clinical response); Geriatric: May have ↓ clinical response with ↑ risk of adverse reactions; Obstetric: Use only if clearly needed; Lactation: Lactation; Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • dizziness


  • eosinophilic pneumonia (life-threatening)
  • dyspnea


  • hypertension
  • hypotension


  • pseudomembranous colitis (life-threatening)
  • constipation
  • diarrhea
  • nausea
  • vomiting
  • ↑ liver enzymes


  • renal failure


  • pruritus
  • rash


  • anemia


  • injection site reactions


  • ↑ CPK


  • fever


Drug-Drug interaction

Tobramycin ↑ blood levels.Concurrent HMG-CoA reductase inhibitors may ↑ the risk of myopathy.


Intravenous (Adults) 4 mg/kg every 24 hr.

Renal Impairment

Intravenous (Adults) CCr <30 mL/min—4 mg/kg every 48 hr.


Powder for injection: 500 mg/vial

Nursing implications

Nursing assessment

  • Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy.
  • Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
  • Monitor for signs and symptoms of eosinophilic pneumonia (new onset or worsening fever, dyspnea, difficulty breathing, new infiltrates on chest imaging studies). Discontinue daptomycin if symptoms occur.
  • Monitor for development of muscle pain or weakness, particularly of distal extremities. Discontinue daptomycin in patients with unexplained signs and symptoms of myopathy in conjunction with CPK elevation >1000 U/L, or in patients without reported symptoms who have marked elevations in CPK >2000 U/L. Consider temporarily suspending agents associated with rhabdomyolysis (HMG-CoA reductase inhibitors) in patients receiving daptomycin.
  • Lab Test Considerations: Monitor CPK weekly, more frequently in patients with unexplained ↑. Discontinue daptomycin if CPK >1000 units/L and signs and symptoms of myopathy occur. In patients with renal insufficiency, monitor both renal function and CPK more frequently.
    • May cause false prolongation of PT and ↑ INR.

Potential Nursing Diagnoses

Risk for infection (Indications,  Side Effects)


  • Do not confuse daptomycin with dactinomycin.
  • Intravenous Administration
  • pH: 4.5.
  • Reconstitute 500-mg vial with 10 mL of 0.9% NaCl inserted toward wall of vial. Rotate vial gently to wet powder. Allow to stand for 10 min undisturbed. Swirl vial gently to completely reconstitute solution. Reconstituted vials are stable for 12 hr at room temperature or 48 hr if refrigerated. Concentration: 50 mg/mL.
  • Rate: Administer over 2 min.
  • Intermittent Infusion: Diluent: Dilute further in 50 mL of 0.9% NaCl. Solution is stable for 12 hr at room temperature or 48 hr if refrigerated. Do not administer solutions that are cloudy or contain a precipitate.
  • Rate: Infuse over 30 min. Do not infuse daptomycin with ReadyMED® elastomeric infusion pumps due to incompatibility.
  • Y-Site Compatibility: alfentanil, amifostine, amikacin, aminophylline, aminocaproic acid, amiodarone, amphotericin B liposome, ampicillin, ampicillin/sulbactam, argatroban, arsenic trioxide, atracurium, azithromycin, aztreonam, bivalirudin, bleomycin, bumetanide, buprenorphine, busulfan, butorphanol, calcium chloride, calcium gluconate, carboplatin, carmustine, caspofungin, cefazolin, cefepime, cefotaxime, cefotetan, cefoxitin, ceftazidime, ceftriaxone, cefuroxime, chloramphenicol, chlorpromazine, ciprofloxacin, cisatracurium, cisplatin, clindamycin, cyclophosphamide, cyclosporine, dacarbazine, dactinomycin, daunorubicin hydrochloride, dexamethasone sodium phosphate, dexmedetomidine, dexrazoxane, diazepam, digoxin, diltiazem, diphenhydramine, dobutamine, docetaxel, dolasetron, dopamine, doripenem, doxacurium, doxorubicin hydrochloride, doxorubicin liposome, doxycycline, droperidol, enalaprilat, epinephrine, epirubicin, eptifibatide, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentanyl, fluconazole, fludarabine, fluorouracil, foscarnet, fosphenytoin, furosemide, ganciclovir, gentamicin, glycopyrrolate, granisetron, haloperidol, heparin, hydralazine, hydrocortisone sodium succinate, hydromorphone, idarubicin, ifosfamide, insulin, irinotecan, isoproterenol, ketorolac, labetalol, leucovorin, levofloxacin, lidocaine, linezolid, lorazepam, magnesium sulfate, mannitol, mechlorethamine, melphalan, meperidine, meropenem, mesna, metaraminol, methyldopate, methylprednisolone sodium succinate, metoclopramide, metoprolol, midazolam, milrinone, mitoxantrone, morphine, moxifloxacin, mycophenolate mofetil, nafcillin, nalbuphine, naloxone, nicardipine, nitroprusside, norepinephrine, octreotide, ondansetron, oxaliplatin, oxytocin, paclitaxel, palonosetron, pamidronate, pancuronium, pemetrexed, pentamidine, phenobarbital, phentolamine, phenylephrine, piperacillin/tazobactam, potassium acetate, potassium chloride, potassium phosphates, procainamide, prochlorperazine, promethazine, propranolol, quinupristin/dalfopristin, ranitidine, rocuronium, sodium acetate, sodium bicarbonate, sodium phosphates, succinylcholine, tacrolimus, teniposide, theophylline, thiotepa, ticarcillin/clavulanate, tigecycline, tirofiban, tobramycin, topotecan, trimethoprim/sulfamethoxazole, vasopressin, vecuronium, verapamil, vinblastine, vincristine, vinorelbine, voriconazole, zidovudine, zoledronic acid
  • Y-Site Incompatibility: acyclovir, alemtuzumab, allopurinol, amphotericin B colloidal, amphotericin B lipid complex, cytarabine, dantrolene, gemcitabine, imipenem/cilastatin, methotrexate, metronidazole, mitomycin, nesiritide, nitroglycerin, pantoprazole, pentazocine, pentobarbital, phenytoin, remifentanil, streptozocin, sufentanil, thiopental, vancomycin
  • Solution Incompatibility: D5W

Patient/Family Teaching

  • Inform patient of purpose of medication.
  • Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.
  • May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Advise patient to notify health care professional immediately if signs and symptoms of eosinophilic pneumonia occur.

Evaluation/Desired Outcomes

  • Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.


a trademark for daptomycin.
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References in periodicals archive ?
Pharmaceutical company Teva Pharmaceutical Industries (NYSE:TEVA) (TASE:TEVA) reported on Friday the availability of an authorised generic of Cubicin (daptomycin for injection) 500 mg per vial in the US.
We continue to articulate the clinical benefits of the drug for appropriate patients, and we are continuing to develop the story around the economic impact that CUBICIN can have in the hospital overall.
Although this study showed that Cubicin is an alternative for all S.
About CUBICIN CUBICIN[R] (daptomycin for injection) is approved in the U.
Cubist Pharmaceuticals, a biopharmaceutical company, has recalled one lot of Cubicin (daptomycin for injection) 500mg in 10ml single use vials, it was revealed on Monday.
Michael Bonney, president and CEO of Cubist said, "In the midst of a deep recession, which has impacted the growth of many companies and stunted economic growth, Cubist has had another strong year supported by the performance of CUBICIN.
Comment: Cubicin binds to bacterial membranes, causing rapid depolarization of membrane potential; this leads to inhibition of protein, DNA, and RNA synthesis, resulting in bacterial cell death.
received Food and Drug Administration approval earlier this month for Cubicin (daptomycin for injections), a once-daily treatment that the biotech company asserts has been proven effective against methicillin-resistant staphylococcus aereus (MRSA) and methicillin-susceptible S.
Surveyed Physicians and Hospital Pharmacy Directors Indicate that Zyvox is More Likely to Be Included on Formularies and Less Likely to Face Prescribing Restrictions Compared with Cubicin, According to a New Report from Decision Resources
M2 EQUITYBITES-April 21, 2014-Cubist Pharmaceuticals announces voluntary nationwide recall of one lot of CUBICIN (daptomycin for injection) 500 mg in 10 ml single use vials
M2 PHARMA-April 21, 2014-Cubist Pharmaceuticals announces voluntary nationwide recall of one lot of CUBICIN (daptomycin for injection) 500 mg in 10 ml single use vials